tbuckley/cabot-search huggingface dataset:
AB0719 IS AORTIC 18FDG-UPTAKE PREVALENCE UNDERESTIMATED? DATA FROM A LARGE HOSPITAL-BASED COHORT
Authors: N. Italiano, F. Di Cianni, P. A. Erba, R. Talarico, M. Mosca
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the most common rheumatologic cause of aortitis, but it is still debated whether clinically isolated aortitis (CIA) represents a variant of such conditions or a nosologically different entity. CIA real frequency may be underestimated since it may occur without specific clinical manifestations. <h3>Objectives</h3> The aim of the present study was to assess the frequency of vasculitic aortic uptake in patients who undergo 18FDG-PET for any kind of clinical reason. <h3>Methods</h3> One-thousand consecutive patients who underwent a whole-body 18FDG-PET at the Nuclear Medicine Department of Pisa Hospital for whatsoever clinical question since January 1<sup>st</sup>, 2019 were enrolled. All the 1000 reports were separately reviewed searching for abnormal uptake of the aorta, and for the doubtful cases the images were revised with an experienced specialist in nuclear medicine. Demographic data, clinical question and provenience was collected; in case of aortic uptake, Meller grade and other sites of abnormal uptake were registered. <h3>Results</h3> The cohort included 439 males and 561 females with a mean age of 62.75 years. The clinical suspicion was neoplasm in 875 cases, infectious process in 55, vasculitis in 25, fever of unknown origin (FUO) in 12, lymphadenopathy in 11, aneurysm in 4 and some other in 18. Thirteen patients (8 males and 5 females, mean age 59.69 years) showed positive aortic uptake. Among them, 6 patients underwent examination for a suspected vasculitis and 7 (53.8%) for other clinical questions (e.g. neoplasm, FUO, polymyalgia rheumatica). Of all the patients who underwent 18FDG-PET for a suspected vasculitis, 7/25 (28%) showed abnormal vascular uptake. Moreover, among the 13 positive patients, three showed isolated aortic uptake while the others also presented other large vessel involvement. Interestingly, in none of the isolated aortitis vasculitis was the clinical question for the examination (arthritis, FUO, myocarditis). <h3>Conclusion</h3> To our knowledge, this is the first hospital-based study aimed to assess the prevalence of 18FDG-PET aortic uptake on such a large-scale cohort. According to our results, 18FDG-PET may result positive despite the absence of clinical vasculitis-related manifestations, especially in case of CIA. For this reason, the actual prevalence of aortic uptake may be underestimated and further wide-scale studies, which are currently ongoing, are expected to better identify the characteristics of CIA patients and their long-term course. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0677 CUT OFF POINT OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AS A MARKER OF DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS AT HAJ ALSAFFE HOSPITAL LUPUS CLINIC FROM JUNE 2021 TO SEPTEMBER 2021
Authors: Z. I. T. Mahmoud, I. S. E. Mohammed, S. B. Hamza
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease with high heterogeneity. SLEDAI is the standardized method to determine disease activity, neutrophils to lymphocytes ratio emerge as new method to detect disease activity. The study aim is to study the neutrophil-to-lymphocyte ratio as a marker of active disease in SLE patients. <h3>Objectives</h3> This study aimed to assess cut off point of neutrophil-to-lymphocyte ratio as a marker of disease activity in systemic lupus erythematosus. <h3>Methods</h3> A cross sectional study was conducted in Haj Al-Safi hospital. A 53 patients were studied using pretested questionnaire, a SLEDAI assessment was conducted to each patient's individually. NLR were measured from collected CBC at the time of the study. Inclusion criteria were: people aged 18 or older, SLE patient diagnosed and confirmed by new 2019 criteria, and exclude any patients with infections, malignancies, and other inflammatory diseases recorded in registry. Data were collected and analyzed using SPSS. <h3>Results</h3> The mean age of patients was (± SD) 39.85 (± 14.07), SLEDI score assessment was conducted for the patients, 48 (90.6 %) scored &gt; 4 and were considered active disease according to the score, 5 (9.4 %) scored &lt;4 and were inactive. The NLR was calculated and the mean was 2.9 (± 2.08). Receiver Operating Characteristic (ROC) was conducted, cutoff (COV) was 2.48. Area Under Curve (AUC) and was AUC=0.402 (95% CI: 0.232 to 0.572, p=0.475).The sensitivity was 47%, and the specificity was 60%. <h3>Conclusion</h3> This findings indicated that the Neutrophil-to-lymphocyte ratio, with a cut-off value (COV) of 2.48, could be utilized to identify the disease activity of systemic lupus erythematosus. Furthermore, by applying this NLR COV. <h3>Disclosure of Interests</h3> None declared
AB1109 TREATMENT RETENTION AND SAFETY OF IXEKIZUMAB IN A POPULATION WITH PSORIATIC ARTHRITIS REFRACTORY TO BIOLOGIC AND TARGETED SYNTHETIC DMARDS
Authors: I. Braña Abascal, S. Burger, P. González del Pozo, E. Pardo Campo, S. Alonso Castro, S. Fernández, F. Jirout, I. Zapico, M. Alperi-López, R. Queiró Silva
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Information on the performance of ixekizumab (IXE) in patients with psoriatic arthritis (PsA) in clinical practice is scarce. <h3>Objectives</h3> We aimed to analyze the retention rate and safety of IXE in patients with PsA in routine clinical practice. The present study has analyzed drug survival and safety of IXE in patients with PsA under real clinical practice conditions. This information may complement that obtained from the RCTs done to date with this drug. <h3>Methods</h3> Retrospective longitudinal observational single-center study of all patients with PsA who had received at least one dose of IXE. Adverse events (AEs) and drug retention rate were considered the main variables. Survival was analyzed using Kaplan-Meier curves and predictive factors using multivariate Cox regression analysis. The Hazard Ratio (HR) was used as a measure of the association. <h3>Results</h3> Seventy-two patients were included (52 women and 20 men). Median disease duration was 5 years (IQR 3-9). More than 90% have received ≥ 2 biologic and/or targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) prior to IXE. Ixekizumab showed a 1-year retention rate of 65% and a 2-year retention rate of 57% (Figure 1). Regarding discontinuation due to AEs, 0.18 AEs per person-year were identified. The number of previous biologics did not influence drug survival but prior use of methotrexate [HR 2.31 (95%CI 1.05-5.10), p &lt; 0.05] and depression [HR 2.40 (95%CI 1.07-5.41), p &lt; 0.05] increased the risk of IXE discontinuation (Table 1). <h3>Conclusion</h3> Ixekizumab demonstrated high drug persistence in a population of PsA mostly refractory to various lines of systemic therapy. In addition, the aspects that usually penalize the survival of most biologics in PsA (age, duration of disease, female gender, smoking, obesity, prior exposure to other biologics) did not affect drug persistence in this study. <h3>References</h3> [1]FitzGerald O, Ogdie A, Chandran V, Coates LC, Kavanaugh A, Tillett W, et al. Psoriatic arthritis. Nat Rev Dis Primers 2021; 7(1):59. [2]Coates LC, Gossec L, Ramiro S, Mease P, van der Heijde D, Smolen JS, et al. New GRAPPA and EULAR recommendations for the management of psoriatic arthritis. Rheumatology (Oxford) 2017; 56(8):1251-1253. [3]Gossec L, Baraliakos X, Kerschbaumer A, de Wit M, McInnes I, Dougados M, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020; 79(6):700-712. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0972 EFFICACY OF TILDRAKIZUMAB IN PATIENTS WITH PSORIASIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Q. Y. Su, H. Zhou, R. T. Shen, W. J. Hao, X. Y. Zhang, Y. X. Li, G. M. Xia, J. Y. Ren, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psoriasis is a common chronic inflammatory disease of the skin[1]. The IL-23/IL-17 immune pathway plays a vital role in promoting Psoriasis pathogenesis[2]. Tildrakizumab, a humanized IgG1 monoclonal antibody against interleukin 23 p19, is currently used in the treatment of patients with psoriasis. <h3>Objectives</h3> This study aimed to evaluate the efficacy of tildrakizumab in the treatment of psoriasis. <h3>Methods</h3> Five databases, including PubMed, Embase, Medline, Web of Science, and Cochrane Library, were retrieved from their establishment to January 2, 2023. We used the EndNote X9 software to filter the retrieved articles according to the inclusion and exclusion criteria. Heterogeneity was tested using I-squared (I2). When I2&gt;50%, we choosed the random effects model for data analysis, conversely, a fixed effects model. Publication bias was assessed using the Egger test. All analyzes were performed in STATA 12.0. <h3>Results</h3> We included 6 studies, 2,395 patients in the Tildrakizumab group and 552 patients in the placebo group (Table 1). Results of the meta-analysis showed that 68% of patients with psoriasis met the PAIS75 remission criteria after taking Tildrakizumab [Rate =0.68 95%CI(0.66, 0.70), P&lt;0.001], and they had significantly higher PASI75 response rates than the placebo group [RR=11.390, 95%CI (8.08, 16.06), P&lt;0.001]. Compared to the placebo group, patients in the Tildrakizumab group had a significantly higher remission rate of PASI90 [RR=26.751, 95%CI (15.282,46.827), P&lt;0.001]. In addition, patients taking Tildrakizumab had an average 15-point reduction in PASI scores [Rate=-14.854 95%CI(-19.146, -10.561), P&lt;0.001], and 45% of patients achieved PASI100 remission criteria [Rate= 0.450, 95%CI (0.131, 0.769), P=0.006] (Figure 1). <h3>Conclusion</h3> This study showed that Tildrakizumab improved disease activity and increased clinical remission rates in patients with psoriasis, demonstrating a better therapeutic effect. <h3>References</h3> [1]Griffiths CEM, Armstrong AW, Gudjonsson JE, et al. Psoriasis. Lancet 2021; 397 (10281): 1301-1315. doi: 10.1016/s0140-6736(20)32549-6. [2]Blauvelt A, Chiricozzi A. The Immunologic Role of IL-17 in Psoriasis and Psoriatic Arthritis Pathogenesis. Clin Rev Allergy Immunol 2018; 55 (3): 379-390. doi: 10.1007/s12016-018-8702-3. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0370 DISORDERS OF PERIPHERAL LYMPHOCYTE SUBSETS IN RHEUMATOID ARTHRITIS PATIENTS COMPLICATED WITH HASHIMOTO’S THYROIDITIS
Authors: T. Cheng, S. X. Zhang, H. Zhang, X. LI
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Hashimoto's thyroiditis (HT) is an organ-specific autoimmune disease that is not rare in RA. Hypothyroidism caused by HT can affect the prognosis and quality of life in patients with RA [1]. Many studies showed that immune cells play a critical role in HT [2-3]. However, the alterations of lymphocyte subsets in RA patients with HT are unclear. <h3>Objectives</h3> This study aimed to assess the absolute numbers and proportions of peripheral lymphocyte subsets in RA with HT and investigate the clinical significance. <h3>Methods</h3> A total of 1636 RA patients and 54 gender- and age-matched healthy controls (HCs) were enrolled in this study. Patients were divided into RA-non-HT and RA-HT groups according to the thyroid peroxidase antibody (TPOAb) and thyroid globulin antibody (TgAb). Peripheral lymphocyte subsets of all participants were assessed by flow cytometry. All clinical and laboratory data were analyzed by SPSS 23.0. <h3>Results</h3> Among 30 (1.83%) RA-HT patients, there were more female (<i>P</i>=0.005), suggesting female was more susceptible to developing HT (Figure 1A). In addition, there were higher levels of erythrocyte sedimentation rate (ESR) (<i>P</i>=0.045) and C-reactive protein (CRP) (<i>P</i>=0.042) than those in RA-non-HT (Figure 1B-C). Compared with those of HCs and RA-non-HT, the level of circulating Th17 in RA-HT patients was significantly increased (<i>P</i>&lt;0.05), while those of Tregs decreased (<i>P</i>&lt;0.05), leading to a higher ratio of Th17/Treg (<i>P</i>&lt;0.01). Notably, the level of B cells and Th1 cells, as well as the Th1/Th2 ratio, increased in the RA-HT compared with those of the RA-non-HT (<i>P</i>&lt;0.05) (Figure 1D-F). <h3>Conclusion</h3> The occurrence of RA-HT is closely related to female patients with high disease activity. Disorders of lymphocyte subsets, especially Th17/Treg imbalance, may contribute to HT in RA, which deserves more clinical attention. <h3>References</h3> [1]Conigliaro P, D'Antonio A, Pinto S, et al. Autoimmune thyroid disorders and rheumatoid arthritis: A bidirectional interplay. Autoimmun Rev. 2020 Jun;19(6):102529. [2]Weetman AP. An update on the pathogenesis of Hashimoto's thyroiditis. J Endocrinol Invest. 2021 May;44(5):883-890. [3]Pyzik A, Grywalska E, Matyjaszek-Matuszek B, et al. Immune disorders in Hashimoto's thyroiditis: what do we know so far? J Immunol Res. 2015;2015:979167. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1830-HPR MUSCULOSKELETAL DISORDERS DURING COVID-19 INFECTION: A SURVEY OF HEALTHCARE WORKERS
Authors: H. Ziedi, D. Brahim, I. Youssef, M. Mersni, Z. Athimni, N. Mechergui, G. Bahri, H. Ben Said, N. Ladhari
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> COVID-19 infection has revealed a considerable number of extra-pulmonary manifestations, especially rheumatological. The detection of these manifestations, which herald the infection, is of great value in the early diagnosis of the disease, especially in health care workers (HCWs) who are at considerable risk of infection. Although myalgia is a common clinical feature of COVID-19, other musculoskeletal disorders (MSDs) have been rarely described. <h3>Objectives</h3> To describe MSDs during SARS-COV2 infection in HCWs. <h3>Methods</h3> Prospective descriptive study conducted at the department of occupational pathology and fitness for work of Charles Nicolle Hospital in Tunis, having included the HCWs affected by COVID-19 during the period from 01 September 2020 to 28 February 2021. Data collection was carried out by regular telephone follow-up during the containment period using a pre-established form. <h3>Results</h3> During the study period, 656 HCWs were infected with SARS COV 2, of whom 134 (20.4%) had at least one musculoskeletal event. The mean age was 42±9 years with a sex ratio (M/F) of 0.2. The most represented occupational category was nurses (33.6%) followed by health technicians (23.1%). The median professional length of service was 12 [7; 20] years. The presence of comorbidity was noted in 58.2% of HCWs. A pre-existing osteoarticular disease was found in 8.2% of cases. Obesity was noted in 25.4% of the population. Active smoking was reported by 14.3% of respondents. A known vitamin D deficiency was noted in 16.5% of patients. Spinal pain was the most reported MSD, present in 87.3% of cases. Low back pain was the most frequent spinal pain (56.7%) followed by back pain (37.4%) and neck pain (5.9%). MSDs of the lower limbs were found in 12.7% of patients. They were represented by gonalgia in 11.9% of cases, ankle pain in 5.2% of cases and hip pain in 4.3% of cases. MSDs of the upper limbs were described by 7.5% of the patients, 92.5% of whom presented with shoulder pain. The median duration of MSDs during COVID-19 was 5 [3; 8] days. These manifestations were persistent on return to work in 21.1% of cases. <h3>Conclusion</h3> Knowledge of the frequency and consequences of musculoskeletal manifestations related to COVID-19 infection is of great importance, particularly in HCWs, in order to optimise management and ensure a rapid return to work. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0586 SERUM/ URINE LEVELS AND EXPRESSION OF CD163 IN LUPUS NEPHRITIS
Authors: E. Gurel, S. Çinar, O. Hurdogan, Y. Ozluk, I. Kilicaslan, S. Varelci, S. Mirioglu, Y. Yalçinkaya, A. Gül, M. L. Ocal, M. Inanc, B. Artim-Esen
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> CD163 is a glycosylated membrane protein expressed in monocytes and macrophages that phagocytize the hemoglobin/haptoglobin complex. As a result of proinflammatory stimuli, CD163 is shedded from the cell membrane and becomes soluble CD163. Therefore, it has been shown that serum (s) and urine (u) levels of soluble CD163 increase in acute or chronic inflammatory diseases. sCD163 and uCD163 are considered as potential biomarkers reflecting disease activity in patients with systemic lupus erythematosus (SLE). <h3>Objectives</h3> We aimed to investigate the association of serum and urine soluble CD163 levels and renal CD163 expression with disease activity in patients with lupus nephritis (LN). <h3>Methods</h3> Serum and urine levels of CD163 of 45 SLE patients (active renal 20, active non-renal 15, inactive 10) and 20 healthy volunteers were tested by ELISA. Control samples were taken from 12 active renal patients after six months of treatment and 30 renal biopsy specimens were examined for CD163 expression. <h3>Results</h3> Of 45 participants, 37 (82.2%) were female, with a median disease duration of 113 (1-436) months and a mean age of 38,9±13 (18-68) years. Both the frequency of uCD163 positivity and its levels were significantly higher in the active LN group compared to the inactive LN (p=0,007 and 0.02 respectively) and active non-renal SLE (p=0,001 and 0.023 respectively) groups (Table 1). sCD163 and uCD163 levels of 12 patients with active LN were significantly reduced after treatment (p=0,04 and p=0,006) (Figure 1). CD163+ macrophage expression in kidney biopsies of patients with active LN correlated with sCD163 (r= 0.597 and p=0.01) and uCD163 (r=0.507 and p=0.045) levels. <h3>Conclusion</h3> uCD163 is a promising biomarker that can differentiate active LN from inactive LN and active extrarenal SLE changing in line with treatment response. Correlation of both s and uCD163 with CD163+ macrophage expression in biopsies suggests that it may be used as an activity parameter in patients with lupus nephritis histopathologically. Further studies are awaited to confirm these results (This study was funded by Istanbul University with the project number TTU-2021-38289) <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0739 PERFORMANCE OF THE 2022 AMERICAN COLLEGE OF RHEUMATOLOGY/EULAR CLASSIFICATION CRITERIA FOR GIANT CELL ARTERITIS IN A COHORT OF PATIENTS WITH SUSPICION OF HAVING GIANT CELL ARTERITIS
Authors: A. Hemmig, M. Aschwanden, S. Imfeld, C. Berger, T. Daikeler
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The new ACR/EULAR 2022 classification criteria for giant cell arteritis (GCA) use weighted items and incorporate findings from vessel imaging to reflect the current clinical standard. Although intended to define homogenous patient populations for research purposes when a diagnosis of medium- or large-vessel vasculitis has been made, the 2022 criteria were developed including non-vasculitis comparators. Hence, in the absence of a sensitive diagnostic gold standard, the criteria bear potential to be used for GCA diagnosis. <h3>Objectives</h3> To evaluate the performance of the new 2022 ACR/EULAR classification criteria for GCA when used for GCA diagnosis. <h3>Methods</h3> Retrospective analysis of a cohort of patients suspected of having GCA who underwent ultrasound between 12/2006 and 05/2021. GCA was diagnosed if temporal artery biopsy was positive, if the 1990 ACR criteria were fulfilled, or if at least 2/5 ACR criteria were fulfilled in combination with vasculitis on imaging. <h3>Results</h3> 276 patients were diagnosed with GCA, and 400 patients had a condition that mimics GCA. When applying the 2022 criteria as diagnostic criteria, sensitivity remained high with 87.3% (95% CI 82.8%–91.0%), whereas specificity was lower with 70.3% (95% CI 65.5% to 74.7%). In 35 patients (12.7%) with GCA, the criteria were not met (Table 1). These were mainly patients without cranial symptoms but having typical imaging findings in vascular territories not considered in the criteria. 119 non-GCA patients (29.8%) scored ≥6 points. Polymyalgia rheumatica (PMR) (31.9%) followed by non-vasculitic ophthalmologic diseases (15.1%) were the most frequent diagnoses among those. <h3>Conclusion</h3> The inclusion of polymyalgic symptoms and heavy weighting of sudden visual loss in the score led to false classification of patients with PMR and ophthalmologic diseases as GCA. For diagnostic purposes, the scoring of the criteria could potentially be adapted by applying a higher cut-off for the diagnosis of GCA or a lower weighting for polymyalgic and visual symptoms. <h3>References</h3> [1]Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol.2022. doi: 10.1002/art.42325. <h3>Acknowledgements</h3> The authors would like to thank the Swiss Foundation for Research on Muscle Diseases (FSRMM) for supporting the Ph.D. of Andrea Hemmig. <h3>Disclosure of Interests</h3> None Declared.